1. Health and Safety Education, Prevention, Promotion in Agriculture Risto Rautiainen, MS Great Plains Center for Agricultural Health

2. Aims Review Ag at Risk Goals Review recent educational programs Assess program effectiveness Conclusions Recommendations

3. Agriculture at Risk Recommendations Legislative 1.2.4. Provide a National Clearinghouse and health information network Education 2. Develop Clearinghouse; identify, collect, list, store, disseminate info on materials and organizations 3. Develop comprehensive set of materials, curriculum 6. Improvement of educational programs for at-risk populations: Evaluation of methodologies used to educate at-risk populations, and initiation of new educational programs Use of set-asides from workers compensation funds for health and safety training Increase the number of training programs through currently established mechanisms

5. Clearinghouse - Dissemination of Educational Materials Videos Books Booklets Brochures Fact sheets Websites Displays

6. Great Plains Center for Agricultural Health – Clearinghouse Project 1996-99 (Rautiainen et al, 2000) 4316 Materials identified 230 Publishers Format: videos (1,162), booklets/brochures (886), abstracts (704), fact sheets (423), slides (175), books (162), and electronic resources (111). Topics: Machinery (699), chemicals (566),injuries (364), special populations (309)

8. South Carolina Farm Leaders for Agricultural Safety and Health (FLASH) Program. Harper (1998): Post-workshop focus groups and interviews Local community educational programs were carried out; educational materials were distributed to 100 local leaders and educators No significant change in attitudes or knowledge of farm safety

9. Media Campaigns Radio TV Farm Journals Newspapers Local papers Internet

10. Information Campaign, Iowa, 1992; messages through radio, newspapers, safety publications. Rodriguez (1997) Baseline and follow-up phone survey of 460 farmers Awareness: mean score increased from 67.25 to 68.88, p=0.035 Concern: mean score increased from 78.50 to 79.91, p=0.011 Behavior: mean score increased from 73.01 to 74.17, p=0.020

11. Educational Events Fairs Trade shows Day camps Meetings Seminars

12. Cass Youth Safety Fair, Cass County Iowa, September 1991. Clarahan (1995) Ages 8-15 years Pre- and post-tests administered on the day of event 27% increase in correct responses to farm safety questions

13. Farm Safety Day Camp, Colorado, 1991. Schmeising (1991) 4 th -6 th grades Pre- and post-tests in participants’ schools Correct responses to questions on farm safety topics increased, depending on topic, from 58-77% compared to pre- tests

14. Farm safety day camps, Fruita & Montrose, Colorado, summer 1992. Buchan (1993) Ages 4-17 years 15-month post-intervention telephone survey of parents Increase in knowledge acquisition ranged from 45 -100%; behavioral changes ranged from 31- 84.5%

15. Community Family Farm Seminars, Iowa, 1995. Burgus (1997) Evening programs on farm safety Post-seminar questionnaires Participants expressed the intention to adopt behavior changes

16. Farm-Church Partnership Project. Reed (1994) Farm safety fair in rural church setting Post questionnaires and informal interviews Farm walk-about checklist completed after returning home and turned in to local feed store for discount Over 50% of participating families indicated that they incorporated safety changes on their farms

17. Health and Safety Training

18. Tractor Certification Programs, WI. Wilkinson (1993) 14-15 years or age Pre and post surveys of youth and parents 15% increase in exposure to non ROPS tractors Carrying extra riders increased slightly Youth riding as an extra rider decreased 9% increase in inspections of tractors Parents reported that their child’s knowledge and behavior improved.

19. Indiana 4-H Tractor Program. Carrabba (2000) 4-6 two hour educational meetings Regional and state tractor operator contest Group of >100 participants studied Participants showed: More tractor exposure time but not more injuries More ROPS and seatbelt use higher scores in starting, driving, obstacle course, dismounting, etc.

20. Safety training for farmer-loggers, Sweden. Jansson (1988) 15 one-day courses with demonstrations over a 3-week period, took place in the forest Post-intervention survey of participants and telephone survey of controls 71% reported a change in working methods Use of protective leg guards increased from 65% to 90%; 40% of controls used them Use of protective boots changed from 65% to 85%; 40% of controls used them

21. Health and Safety Networks Membership Information Other services

22. Saskatchewan agricultural health and safety network. Hagel et al (1999) Established 1988 21,500 members, 38% of SK farmers $10 CAD annual fee Educational materials, events, consultation, seminars, health screenings, website Strong participation demonstrates need

23. Farm Hazard Identification Programs

24. Farm Safety Walkabout, Iowa. Hawk (1995) Conducted 1990-91 Groups: extension/FFA, health professional, and farm families on their own Pre-test- post-test Each group had significant change in behavior scores (p<0.001) Having a professional help administer the program on the farm improved effectiveness

25. Agricultural Safety and Health Best Management Practices Manual (BMP). Legault and Murphy (2000) Hazard audits on the farm, standard assessment method Baseline and post intervention audits on 150 PA farms 3 groups; BMP, education, control BMPM group reduced hazards most

26. Comprehensive Occupational Health Service Programs

27. Certified Safe Farm Program, Iowa, Nebraska. Donham et al. (2000) Health Screening, Education, On-farm safety review, Rebate ($200/year) >125 intervention, >125 control farms Follow-up of health outcomes and exposures Preliminary results: Some reductions in self reported numbers of health outcomes and serious injuries Improvements in farm safety review scores Reductions in dust, gas, noise exposures

28. Reindeer husbandry safety, Finland. Pekkarinen (1992) Conducted in Lapland, 1985-87 Questionnaire identified high risk behaviors; herders were educated at health exams and by letter about 34 safety recommendations Pre/post questionnaires Herders implemented an average of 5.8 measures per herder in 1987 Injury incidence decreased from 21 injuries/1000 work days in 1985 to 12/1000 work days in 1987

29. West Jutland Study, Denmark. Carstensen (1998) Randomized intervention of 200 farms Intervention group had a farm inspection and one-day safety course Injury surveillance and behavior checks Intervention: reduction from 33.4 to 20.1 injuries per 100,000 work hours (p<0.05); improvement in behaviors for 66 work routines Control: no reduction in injury incidence, no improvement in behaviors

30. National model for farmer’s occupational health services, Finland. Husman (1990) Model evaluation study 1979-88 Farm visit or interview, recommendations, education, clinical physical exam, follow-up every two years Pre/post intervention survey of participants and controls Increase in knowledge and use of PPE No improvement in working conditions, e.g. changes in engineering and work practices

31. Conclusions Universities, Extension, Ag Centers, and national organizations have Clearinghouse functions but no single major clearinghouse exists Materials were developed in the early 1990’s; many are available through NIOSH/NASD Many materials were duplicative and are currently in need of update. Education is necessary but education alone is not adequate – works well as part of comprehensive programs Education relies on repeating the message and constantly developing new approaches

32. Conclusions (Cont.) Most educational program evaluation studies showed some degree of success. Evaluation methods were limited to pre/post test design. Most studies measure self reported knowledge, attitude or behaviors – not injuries or illnesses Knowledge -> attitude -> behavior -> reduced injuries/illnesses?

33. Agriculture at Risk Recommendations Legislative 1.2.4. Provide a National Clearinghouse and health information network B- Education 2. Develop Clearinghouse; identify, collect, list, store, disseminate info on materials and organizations B- 3. Develop comprehensive set of materials, curriculum C 6. Improvement of educational programs for at-risk populations: Evaluation of methodologies used to educate at-risk populations, and initiation of new educational programs C Use of set-asides from worker compensation funds for health and safety training F Increase the number of training programs through currently established mechanisms B-

34. Recommendations Develop a National Action Plan for Health and Safety Education Develop a National Clearinghouse for Agricultural Health and Safety Resources Enhance National and State information dissemination networks for farmers Evaluate model educational and informational programs and use sound evaluation methods to assess the effectiveness